Health in Burundi

The Ministry of Public Health and the Fight against AIDS (Ministère de la Santé Publique et de la Lutte contre le SIDA) directs and regulates the national health system. Healthcare follows a pyramid structure with central, intermediate, peripheral, and community levels. Provincial health offices (BPS), district health offices (BDS), and formal health facilities (FOSA) organize practical care. These include health centers (Centre de Santé (CDS)), community hospitals, and district, regional, and national hospitals. Community health workers (Agents de Santé Communautaire (ASC)) provide information, detect illnesses early, conduct home visits, and arrange referrals when needed. Mobile clinics and outreach treatment posts supplement care in hard-to-reach or humanitarian areas. Prevention includes vaccinations, antenatal and postnatal care, family planning, nutrition screening, and malaria prevention. Routine malaria vaccination with RTS,S started on March 17, 2025, initially for children aged 6 to 11 months in 25 districts and 9 provinces. HPV vaccination was introduced nationwide in April 2026 and targets girls aged 9 to 14, both in and outside school. A planned installation of solar-powered refrigeration in 80 facilities is intended to improve the vaccine cold chain; by May 2025, 28 facilities had been equipped. Malaria is the leading cause of illness and death. Other significant burdens include diarrheal diseases, respiratory infections, vaccine-preventable diseases, HIV, tuberculosis, cholera, measles, polio, and malnutrition. Noncommunicable diseases, mental health, and cancer are gaining strategic importance, but related services are not equally available everywhere. The availability of basic services was 61.6 percent in 2022; for older people it was lower, at 50.7 percent, than for pregnant women and newborns, at 74.5 percent. Access depends heavily on distance, roads, transport, electricity supply, available medicines, diagnostics, staff, and opening hours. Long journeys can be necessary in rural areas; in Ruhororo, a 12-kilometer return journey was documented, while the nearest vaccine-cooling facility was 20 kilometers away. Medicine shortages and unlicensed sales make treatment more difficult. Traditional healers and traditional birth attendants continue to operate as informal parallel options, but their formal quality and referral effectiveness have not been established. Health policy provides free services for pregnant women and children under five. According to a 2021 UNICEF report, a birth certificate may be required for children under five to receive free care; current implementation and possible exceptions have not been independently confirmed. Even when treatment is free, transport, unavailable medicines, referrals, and other indirect costs may arise. Current national tariffs, reimbursement deadlines, general opening hours, and a nationally confirmed emergency number are not reliably available. In an emergency, the first facility stabilizes the patient and refers them, as needed, to a community, district, regional, or national hospital. After treatment, continuity depends on whether return referrals, follow-up care, and medicine supplies function properly. The health information system (SNIS) and health information platform (DHIS2) have been expanded, but the linking of medical records between facilities remains limited. For epidemics, the public health emergency operations center (COUSP) coordinates the public health emergency response through surveillance, triage, isolation, and referral. Formal complaint procedures and a current national patient rights charter could not be confirmed.